Out-of-the-Box Solutions for HIV/AIDS Treatment in Uganda

In rural Uganda, chicken coops and farms are saving the lives of HIV/AIDS patients. But it’s no herbal remedy — it’s an economic one, and a Massachusetts General Hospital physician is spearheading the initiative.

David Bangsberg, MD, MPH, director of the Massachusetts General Hospital’s Center for Global Health, has been working in Uganda for years, finding ways to better treat HIV/AIDS patients through improved clinical training, research and care delivery. More than 33 million people residing in sub-Saharan Africa are HIV-infected, representing 67 percent of the world’s HIV pandemic. But while HIV/AIDS has become a chronic illness in the developed world thanks to antiretroviral therapy, it remains the leading cause of death in young adults in many sub-Saharan countries, including Uganda.

During his many years traveling to Uganda, where 1.2 million people are infected, Dr. Bangsberg developed a keen sense that simply providing treatment to patients isn’t nearly enough to keep them alive and healthy: so many infected Ugandans are simply too poor to pay for transportation to medical clinics to pick up medication, which also means taking a day off from work, causing lost income. That leads to lapses in treatment, and thus to drug resistance. And they are too poor to buy enough food.

“Families can now cover the ancillary cost of care and don’t have to make a decision between paying for transportation to get their drugs and paying for food. And they are staying healthy.”– Dr. David Bangsberg, MGH Center for Global Health

The Sustainable Household Income Project (SHIP) is based on the premise that, if economic barriers can be breached, HIV-infected people will be able to purchase life-saving medication. Under SHIIP, rural Ugandan families affected by HIV build and maintain their own chicken coops. The coops, in turn, generate income that allowed the families to get their medications. The financial model was developed by Massachusetts Institute of Technology economists.